DOCSLIB.ORG

Effect of Helicobacter Pylori Infection on Colloidal

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Effect of Helicobacter Pylori Infection on Colloidal 592 Gut, 1992, 33, 592-596 Effect ofHelicobacterpylori infection on colloidal bismuth subcitrate concentration in gastric mucus Gut: first published as 10.1136/gut.33.5.592 on 1 May 1992. Downloaded from D J B Mufnoz, C Tasman-Jones, J Pybus Abstract bacterpylori. Movement ofa drug into mucus will Necropsy gastric mucus infected with Helico- be determined by its intragastric availability. bacter pylon has a reduced capacity to con- Availability will depend upon various factors centrate colloidal bismuth subcitrate when including the drug's behaviour in solution. compared with non-infected mucus. Mucus It is not known whether non-infected and mounted in a modified in vitro diffusion Helicobacter pylon infected mucus differ in their chamber was bathed with colloidal bismuth capacity to contain colloidal bismuth subcitrate subcitrate solutions at different concentra- and little is known on the behaviour of colloidal tions and pH levels. Bismuth was measured by bismuth subcitrate in solution. atomic absorption spectrophotometry to In this in vitro study we have examined the assess intramucus colloidal bismuth subcitrate effect of Helicobacter pylon' infection on the concentrations. Bismuth concentrations in capacity ofgastric mucus to concentrate colloidal non-infected mucus were higher than in bismuth subcitrate and the behaviour ofcolloidal Helicobacter pylori infected mucus at all bismuth subcitrate in acidic solutions. experimental colloidal bismuth subcitrate con- centrations and pH levels. Regardless of the infection status, the intramucus concentration Methods of colloidal bismuth subcitrate was dependent upon the concentration of the bathing solution SPECIMENS and independent of the pH and the mucus Mucus from 20 human stomachs was collected at thickness. Colloidal bismuth subcitrate solu- necropsy within 24 hours of death. All persons bility in saline solution varied with pH. (18-75 years) had died ofacute trauma or sudden http://gut.bmj.com/ and was least soluble in the pH range 1 1 to unexpected medical collapse. Each stomach was 3-25 and more soluble above and below this pH opened along the greater curvature and food range. This study suggests that Helicobacter contents were removed by washing with normal pylon infection is associated with physico- saline. chemical changes in the gastric mucus with a Mucus was harvested by gently scraping the reduction in its capacity to concentrate col- gastric mucosa with a glass slide and stored at loidal bismuth subcitrate. Such a reduction -20°C for later experiments. on September 23, 2021 by guest. Protected copyright. may compromise the attainment of optimum Immediately before harvesting, a gastric tissue colloidal bismuth subcitrate concentrations specimen was taken for Helicobacterpylori urease necessary for its bactericidal activity. detection by the camplobacter like organism test (CLO test, Delta West Limited, Western Aus- tralia).34 Gastric mucus plays an important role in A mucus sample was considered infected with mucosal protection.' Disruption in the Helicobacter pylori when the tissue specimen integrity of the blanket of mucus has been found showed positive urease activity within one hour in individuals with peptic ulcer.8"12 Helicobacter with the CLO test and non-infected when the pylori present in gastric mucus of the stomach tissue specimen showed no positive urease or duodenal gastric metaplasia is associated with activity within 24 hours. gastritis and peptic ulceration.'3 22 Helicobacter Department of pylori resides in gastric mucus but not within Medicine, School of epithelial cells.2"24 It may play a role in mucin COLLOIDAL BISMUTH SUBCITRATE Medicine, University of Auckland, Auckland, breakdown.25-27 CONCENTRATION IN GASTRIC MUCUS New Zealand Eradication of Helicobacter pylori by colloidal The modified in vitro diffusion chamber pre- D J B Munioz bismuth subcitrate is followed by histological viously used for ion exchange studies on mucus` C Tasman-Jones improvement of gastritis and healing of peptic was used to expose gastric mucus to colloidal Department of Clinical ulcer.242829 If infection recurs, ulcer relapse is bismuth subcitrate. Chemistry, Auckland frequent, particularly after one year.2430 31 Mucus (115 + 1 mg or 230 ± 1 mg, depending Hospital, Auckland, New A combination of colloidal bismuth subcitrate on mucus layer thickness) was held between two Zealand with one or two antibiotics - fQr fine gauze mesh discs Swiss J Pybus example, (Nybolt PA-22/17; is more Correspondence to: amoxycillin and/or metronidazole, Silk Bolting Cloth Mfg Co Ltd, Zurich, Switzer- Dr C Tasman-Jones, successful than monotherapy in eradicating land) separated by a plastic ring to form a layer Department of Medicine, School of Medicine, Helicobacterpylor 24323 400 ,im or 800 iim thick. The mucus containing University of Auckland, Ulcer relapse after colloidal bismuth sub- cassette was held in the chamber by two rigid Private Bag, Auckland, New Zealand citrate and other antibiotics may be the result mesh discs (Tetex Mono PES 130/TWL/C; Accepted for publication of a failure of the drug(s) to reach sufficient Swiss Silk Bolting Cloth Mfg Co Ltd, Zurich, 5 August 1991 intramucus concentrations to eradicate Helico- Switzerland). One side of the mucus was bathed Effect ofHelicobacter pylori infection on colloidal bismuth subcitrate concentration in gastric mucus 593 with saline solution adjusted to pH 6.0 and the different pH's. For each pH, one 60 ml test tube other side with filtered solutions (Filter Paper 1, containing 45 ml saline and one whole commer- Whatman International Ltd, Maidstone, cial tablet of colloidal bismuth subcitrate was England) of colloidal bismuth subcitrate (De- 'tumbled' in the Chiltern rotatory mixer (Chiltern Gut: first published as 10.1136/gut.33.5.592 on 1 May 1992. Downloaded from Nol®, Gist-Brocades, Delft, The Netherlands) Scientific, Germany) at a rate of 32 'tumbles' per at different concentrations (as bismuth) and minute. Disintegration was assessed visually and pH's as follows: halfand total disintegration times were recorded. Series 1: Colloidal bismuth subcitrate 93 To determine if the outer coating of the com- mg/l, pH 6.0, mucus layer 800 [im thick. mercial tablet affects disintegration, tablets were Series 2: Colloidal bismuth subcitrate 232 stripped of their coating and exposed to saline mg/l, pH 6-0, mucus layer 400 ,um thick. solutions under the same conditions as above. Series 3: Colloidal bismuth subcitrate 64 mg/l, pH 6.0, mucus layer 400 iim thick. Series 4: Colloidal bismuth subcitrate 64 STATISTICAL ANALYSIS mg/l, pH 1 5, mucus layer 400 [tm thick. Results for colloidal bismuth subcitrate concen- Series 5: Colloidal bismuth subcitrate 127 tration experiments were expressed as mean mg/l, pH 1 5, mucus layer 400 [im thick. (SD). A general linear approach to the analysis of The solutions were continuously circulated for variance37 was used to determine the statistical 90 minutes at a rate of 4 5 ml/min, room significance of differences in bismuth concen- temperature 2 1C. tration between non-infected and Helicobacter After each experiment the excess of colloidal pylori infected mucus. Significant mean and bismuth subcitrate solution was washed off with interaction effects were further investigated saline. The mucus was taken out of the chamber using Tukey's procedure to analyse differences and dried at 1 10°C for four hours. within pH's and mucus thickness. Type III sums The bismuth content of the samples was of squares are presented because the design was measured by atomic absorption (Graphite unbalanced. p Values of less than 0.05 were Furnace Atomic Absorption Spectrophotometer considered significant. SpectrAA-20; Melbourne, Australia) to assess the intramucus colloidal bismuth subcitrate concentrations. Results were expressed as [tg Results bismuth/g mucus on the assumption that all mucus samples contain 95% water.36 The possi- COLLOIDAL BISMUTH SUBCITRATE bility that Helicobacter pylon infection may CONCENTRATION IN GASTRIC MUCUS modify the water content has not been con- The Table shows mean (SD) and range bismuth http://gut.bmj.com/ sidered in this study. concentrations in non-infected and Helicobacter pylon infected gastric mucus. Bismuth concentrations were higher in non- COLLOIDAL BISMUTH SUBCITRATE SOLUBILITY infected than in Helicobacter pylon infected Normal saline solutions were adjusted to dif- mucus at all experimental colloidal bismuth ferent pH's (E512 Metrohm Herisau pH meter, subcitrate concentrations and pH levels (F(1,62)= Switzerland). Commercial tablets of colloidal 52.86, p=00001). on September 23, 2021 by guest. Protected copyright. bismuth subcitrate stripped of their outer coat- Regardless of the infection status, bismuth ing were ground to a homogeneous powder. concentrations varied in proportion to the con- Weighed samples of the powder were added to centration of the bathing solution and were no saline to give mixtures with the same weight/ different at mucus thickness 400 iim or 800 ,tm volume ratio. After colloidal bismuth subcitrate and at pH 1.5 or 6.0 (F(s,62)=l106, p=0.0389). was dissolved in the saline solution, samples In separate experiments, using unfiltered were obtained from the supernatant and colloidal bismuth subcitrate solutions and no fine analysed for bismuth content by atomic absorp- gauze mesh we found that a whitish precipitate tion spectrophotometry. Colloidal bismuth sub- was deposited on the mucus surface after the citrate solubility was estimated by calculating the experiments,
Load more

Recommended publications
  • Combination Therapy for Peptic Ulcer Treatment
    Office europeen des brevets © Publication number: 0 480 691 A2 © EUROPEAN PATENT APPLICATION © Application number : 91309249.0 © int. ci.5: A61K 33/24, A61K 31/60, A61K 31/44, A61K 31/425, © Date of filing : 09.10.91 //(A61K33/24, 31:44, 31:425), (A61K31/60, 31:44, 31:425), (A61K31/44, 31:195), (A61K31/425, 31:195) © Priority: 11.10.90 US 595908 © Inventor: Berlin, Roger G. 519 Mulberry Lane Haverford, PA 19041 (US) (43) Date of publication of application : 15.04.92 Bulletin 92/16 @ Representative : Thompson, John Dr. et al Merck & Co., Inc. European Patent @) Designated Contracting States : Department Terlings Park Eastwick Road CH DE FR GB IT LI NL Harlow, Essex CM20 2QR (GB) © Applicant : MERCK & CO. INC. 126, East Lincoln Avenue P.O. Box 2000 Rahway New Jersey 07065-0900 (US) © Combination therapy for peptic ulcer treatment. © Peptic ulcer disease is treated with a combination therapy of famotidine or omeprazole plus a bismuth salt. CM < CO o 00 LU Jouve, 18, rue Saint-Denis, 75001 PARIS EP 0 480 691 A2 BACKGROUND OF THE INVENTION In the past, treatment of peptic ulcer disease was based on either neutralization of intragastric acidity with antacids or the inhibition of production of acid secretion by H2-receptor antagonists or by proton pump inhibition 5 among others. Using bismuth salts alone to heal ulcers has been shown to be effective presumably because of its effect on Helicobacter pylori. Relapse of Helicobacter positivity, however, has been a problem as has relapse of ulcer disease in patients treated with antisecretory therapy.
    [Show full text]
  • The Toronto Consensus for the Treatment of Helicobacter Pylori Infection in Adults Carlo A
    Gastroenterology 2016;151:51–69 CONSENSUS STATEMENT The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults Carlo A. Fallone,1 Naoki Chiba,2,3 Sander Veldhuyzen van Zanten,4 Lori Fischbach,5 Javier P. Gisbert,6 Richard H. Hunt,3,7 Nicola L. Jones,8 Craig Render,9 Grigorios I. Leontiadis,3,7 Paul Moayyedi,3,7 and John K. Marshall3,7 1Division of Gastroenterology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada; 2Guelph GI and Surgery Clinic, Guelph, Ontario, Canada; 3Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada; 4Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; 5Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; 6Gastroenterology Service, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain; 7Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada; 8Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Departments of Paediatrics and Physiology, University of Toronto, Toronto, Ontario, Canada; and 9Kelowna General Hospital, Kelowna, British Columbia, Canada This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e25. Learning Objective: Upon completion of this examination, successful learners will be able to establish a treatment plan for patients with H pylori infection. BACKGROUND & AIMS: Helicobacter pylori infection is lthough the prevalence of H pylori is decreasing in increasingly difficult to treat. The purpose of these consensus A some parts of the world, the infection remains pre- statements is to provide a review of the literature and specific, sent in 28% to 84% of subjects depending on the population updated recommendations for eradication therapy in adults.
    [Show full text]
  • Levofloxacin, Metronidazole, and Lansoprazole Triple Therapy Compared to Quadruple Therapy As a Second-Line Treatment of Helicobacter Pylori Infection in Korea
    Gut and Liver, Vol. 7, No. 4, July 2013, pp. 406-410 ORiginal Article Levofloxacin, Metronidazole, and Lansoprazole Triple Therapy Compared to Quadruple Therapy as a Second-Line Treatment of Helicobacter pylori Infection in Korea Ji Yoon Moon*, Gwang Ha Kim*, Hyun Seok You†, Bong Eun Lee*, Dong Yeop Ryu*, Jae Hoon Cheong*, Jung Im Jung*, Jae Hoon Jeong‡, Chul Soo Song‡, and Geun Am Song* *Department of Internal Medicine, Pusan National University School of Medicine, †Department of Internal Medicine, Busan Medical Center, and ‡Department of Internal Medicine, Good Samsun Hospital, Busan, Korea Background/Aims: Several rescue therapies have been rec- INTRODUCTION ommended to eradicate Helicobacter pylori infection in pa- tients with a failure of first-line eradication therapy, but they Helicobacter pylori infection is recognized as an important still fail in more than 20% of cases. The aim of this study was contributor to nonulcer dyspepsia, peptic ulcer disease, gastric to evaluate the efficacy and safety of levofloxacin, metroni- mucosa-associated lymphoid tissue lymphoma, and gastric dazole, and lansoprazole (LML) triple therapy relative to qua- cancer. Eradication of H. pylori significantly reduces the re- druple therapy as a second-line treatment. Methods: In total, lapse rate of peptic ulcer disease.1,2 A triple therapy, comprising 113 patients who failed first-line triple therapy for H. pylori amoxicillin, clarithromycin, and a proton pump inhibitor (PPI), infection were randomly assigned to two groups: LML for 7 is the first-line treatment suggested by international guide- days and tetracycline, bismuth subcitrate, metronidazole and lines.3-5 However, several large clinical trials have shown that lansoprazole (quadruple) for 7 days.
    [Show full text]
  • Designation of Pharmaceuticals Required Securing
    Designation of Pharmaceuticals Required securing Pharmaceutical Equivalence Ministry of Food & Drug Safety Notification No. 2014- 189 (Nov. 26, 2014, Amended) Article 1 (Purpose) In accordance with Article 31(2) and 42(1) of the 「Pharmaceutical Affairs Act」, Articles 4(1)(3) of the 「Regulation on Safety of Medicinal Products, etc.」 and Article 57 of the 「Narcotics Control Act.」, the purpose of this Notification is to set forth the appropriate standards for Pharmaceuticals approval by providing for designates pharmaceuticals required to submit bioequivalence study results and comparative clinical study results, and also designates pharmaceuticals required to submit test results of not using biological matters such as comparative dissolution test in the approval of pharmaceutical manufacturing/marketing and import. Article 2 (Designation of pharmaceuticals requiring pharmaceuticals equivalence test) ① In accordance with Article 4(1)(3)(b) of the 「Regulation on Safety of Medicinal Products, etc..」, Tablets, capsules, or suppository of which ingredients are the same as previously approved pharmaceuticals for manufacturing/marketing and import, are one of the following subparagraph. 1. Conventional pharmaceuticals, their salts and derivatives comprised of a single active pharmaceutical ingredient as listed in the attached Table 1, which are determined by the claim quantity of medical expense of health insurance submitted to the President of Health Insurance Review and Assessment Service by the healthcare institutions as described in Article 43 of the 「National Health Insurance Act」. 2. Expensive pharmaceuticals, their salts and derivatives comprise of a single active pharmaceutical ingredient as listed in the attached Table 2, which are determined by the invoiced amounts of medical expense of health insurance divided by the claim quantity submitted to the President of Health Insurance Review and Assessment Service by the healthcare institutions as described in Article 43 of the 「National Health Insurance Act」.
    [Show full text]
  • OMECLAMOX-PAK (Omeprazole, Clarithromycin, and Amoxicillin) PREVPAC (Lansoprazole, Clarithromycin, and Amoxicillin) PYLERA (Bism
    OMECLAMOX-PAK (omeprazole, clarithromycin, and amoxicillin) PREVPAC (lansoprazole, clarithromycin, and amoxicillin) PYLERA (bismuth subcitrate, metronidazole, tetracycline) TALICIA (omeprazole, amoxicillin, and rifabutin) RATIONALE FOR INCLUSION IN PA PROGRAM Background Prevpac and Omeclamox-Pak are a copackaged product containing a proton pump inhibitor, a macrolide antimicrobial, and a penicillin class antibacterial that, when taken together, is indicated for the eradication of Heliobacter pylori infection in patients with duodenal ulcer disease that is active or up to a one year history. Pylera is a copackaged product containing two antimicrobials; metronidazole, tetracycline and bismuth subcitrate potassium. Pylera is also used to eradicate Helicobacter pylori (H. pylori) in patients with H. pylori infection and duodenal ulcer disease; Pylera is FDA-approved for use only in combination with omeprazole. Talicia is a three-drug combination of a proton pump inhibitor, a penicillin-class antibacterial, and a rifamycin antibacterial. Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence (1-4). It is important to treat H. pylori infection because it has been identified as a risk factor in the development of peptic ulcer, duodenal ulcer, atrophic gastritis, gastric cancer, and mucosal- associated lymphoid tissue (MALT) lymphoma, as well as, a possible risk factor for the development idiopathic thrombocytopenic purpura and anemia (1-4). Regulatory Status The components in Prevpac, Pylera and Omeclamox-Pak are indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or one-year history of a duodenal ulcer) to eradicate H. pylori (1-3). The components in Talicia are indicated for the treatment of H.
    [Show full text]
  • Australian Statistics on Medicines 1997 Commonwealth Department of Health and Family Services
    Australian Statistics on Medicines 1997 Commonwealth Department of Health and Family Services Australian Statistics on Medicines 1997 i © Commonwealth of Australia 1998 ISBN 0 642 36772 8 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be repoduced by any process without written permission from AusInfo. Requests and enquiries concerning reproduction and rights should be directed to the Manager, Legislative Services, AusInfo, GPO Box 1920, Canberra, ACT 2601. Publication approval number 2446 ii FOREWORD The Australian Statistics on Medicines (ASM) is an annual publication produced by the Drug Utilisation Sub-Committee (DUSC) of the Pharmaceutical Benefits Advisory Committee. Comprehensive drug utilisation data are required for a number of purposes including pharmacosurveillance and the targeting and evaluation of quality use of medicines initiatives. It is also needed by regulatory and financing authorities and by the Pharmaceutical Industry. A major aim of the ASM has been to put comprehensive and valid statistics on the Australian use of medicines in the public domain to allow access by all interested parties. Publication of the Australian data facilitates international comparisons of drug utilisation profiles, and encourages international collaboration on drug utilisation research particularly in relation to enhancing the quality use of medicines and health outcomes. The data available in the ASM represent estimates of the aggregate community use (non public hospital) of prescription medicines in Australia. In 1997 the estimated number of prescriptions dispensed through community pharmacies was 179 million prescriptions, a level of increase over 1996 of only 0.4% which was less than the increase in population (1.2%).
    [Show full text]
  • Bismuth Subcitrate
    HIGHLIGHTS OF PRESCRIBING INFORMATION • Tooth Enamel discoloration and hypoplasia: permanent discoloration may These highlights do not include all the information needed to use develop with use during tooth development (last half of pregnancy, PYLERA safely and effectively. See full prescribing information for infancy, and childhood to the age of 8 years). (5.4) PYLERA • Central and Peripheral Nervous System Effects: encephalopathy, ® convulsive seizures, aseptic meningitis and peripheral neuropathy with PYLERA (bismuth subcitrate potassium, metronidazole, tetracycline metronidazole, intracranial hypertension with tetracycline and hydrochloride) capsules, for oral use neurotoxicity with bismuth-containing products. Monitor patients with Initial U.S. Approval: 2006 CNS conditions closely and discontinue promptly if abnormal neurologic signs develop. (5.5) WARNING: POTENTIAL FOR CARCINOGENICITY • Photosensitivity: avoid exposure to sun and sun lamps. (5.7) See full prescribing information for complete boxed warning • Blood Dyscrasias: Use with caution in patients with a history of blood dyscrasias (5.9) Metronidazole has been shown to be carcinogenic in mice and rats. It is • Hepatic Impairment: Use with caution in patients with hepatic unknown whether metronidazole is associated with carcinogenicity in impairment. (5.10) humans (5.1). • Cutaneous Reactions: Stevens-Johnson, toxic epidermal necrolysis, DRESS syndrome. Discontinue treatment at the first evidence of a ----------------------------RECENT MAJOR CHANGES--------------------------
    [Show full text]
  • H. Pylori Infection Products
    Drug and Biologic Coverage Policy Effective Date ............................................ 7/1/2021 Next Review Date… ..................................... 7/1/2022 Coverage Policy Number ............................... IP0009 H. Pylori Infection Products Table of Contents Related Coverage Resources Overview .............................................................. 1 Coverage Policy Statement ................................. 1 FDA Indication Criteria ......................................... 2 Other Uses with Supportive Evidence Criteria .... 2 Specific Additional Criteria ................................... 2 Preferred Product Requirement Criteria .............. 2 Conditions Not Covered....................................... 3 Background .......................................................... 3 References .......................................................... 4 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD)
    [Show full text]
  • Stability of Metronidazole, Tetracycline Hcl and Famotidine Alone and in Combination
    International Journal of Pharmaceutics 290 (2005) 1–13 Stability of metronidazole, tetracycline HCl and famotidine alone and in combination Yunqi Wua, Reza Fassihib,∗ a Product Development, Scolr Pharma, Inc., Bellevue, Washington, USA b Temple University, School of Pharmacy, Department of Pharmaceutical Sciences, 3307 N. Broad St., Philadelphia, PA 19140, USA Received 25 June 2004; received in revised form 22 October 2004; accepted 22 October 2004 Abstract Metronidazole, tetracycline HCl and famotidine are commonly used for the treatment of Helicobacter pylori-associated peptic ulcer. In this paper, stabilities of these drugs and their combinations in solid and liquid states were studied as part of preformulation in the development of a combination drug delivery system. Solubility studies of metronidazole and tetracycline HCl were investigated, which indicated that both metronidazole and tetracycline HCl have high solubilities at and around pH 2.0. Metronidazole is relatively stable with little degradation in liquid phase. Tetracycline HCl in the dry state is stable when stored at room temperature regardless of exposure to light or humidity in the range of 20–65%. Enhanced temperature associated humidity effect was responsible for the instabilities of tetracycline HCl and famotidine to different extents. Elevated temperature accelerated the degradation of all the drugs in liquid phase but light exposure was not a factor for the degradation. The degradation processes of tetracycline HCl and famotidine were highly dependent on the pH of the solution, and relatively stable profiles were achieved at pH 4.0. No potential incompatibility between the drugs under storage conditions was observed in the development of a new multi-drug delivery tablet.
    [Show full text]
  • Bismuth Salts for Gastrointestinal Issues: a Review of the Clinical Effectiveness and Guidelines DATE
    TITLE: Bismuth Salts for Gastrointestinal Issues: A Review of the Clinical Effectiveness and Guidelines DATE: 24 November 2015 CONTEXT AND POLICY ISSUES Oral bismuth formulations have been used effectively for prophylaxis and treatment of both diarrhea and for treatment of Helicobacter pylori (H. pylori) infection.1,2 Bismuth formulations available without a prescription have been commonly used to treat episodic diarrhea for over a century. Bismuth has also been used to treat ulcers prior to the appreciation of its antimicrobial activity against the then unknown causative micro-organism, H. pylori.1 Episodes of diarrhea are especially common in travelers to resource-poor countries. It is estimated that 30% to 70% of international travelers will develop diarrhea during travels or upon return. Typically diarrhea is self-diagnosed and the causal infectious agent remains unknown. While the condition is frequently self-limiting, treatment can reduce the duration, severity, and inconvenience of diarrhea while travelling. Commonly used treatments include antibiotics, antimotility agents, oral rehydration solutions, and bismuth subsalicylate.2 H. pylori infection is a substantial public health concern as it plays a causative role in the pathogenesis of many gastrointestinal conditions such as gastritis, peptic ulcers, and gastric cancer.3 Current treatment regimens designed to eradicate infection utilize more than one antibiotic simultaneously in a standard triple therapy (STT) consisting of a proton-pump inhibitor (PPI), and two antibiotics.
    [Show full text]
  • Prevention of Gastric Ulcers
    24 Prevention of Gastric Ulcers Mohamed Morsy and Azza El-Sheikh Pharmacology Department, Minia University Egypt 1. Introduction Upper gastrointestinal tract integrity is dependent upon the delicate balance between naturally occurring protective factors as mucus or prostaglandins and damaging factors as hydrochloric acid present normally in the digestive juices. An imbalance causes peptic ulcer formation and destruction of gastrointestinal tract mucosal lining. Ulcer may develop in the esophagus, stomach, duodenum or other areas of elementary canal. In women, gastric ulcers are more common than duodenal ulcers, while in men the opposite is true. The ulcer irritates surrounding nerves and causes a considerable amount of pain. Obstruction of the gastrointestinal tract may occur as a result of spasm or edema in the affected area. The ulcer may also cause the erosion of major blood vessels leading to hemorrhage, hematemesis and/or melena. Deep erosion of the wall of the stomach or the intestine may cause perforation and peritonitis, which is a life-threatening condition needing emergency intervention. Duodenal ulcers are almost always benign but stomach ulcers may turn malignant. Although mortality rates of peptic ulcer are low, the high prevalence of the disease, the accompanying pain and its complications are very costly. The ongoing rapidly expanding research in this field provides evidence suggesting that, with therapeutic and dietetic advances, gastric ulcer may become preventable within the next decade. This could be achieved by strengthening the defense mechanisms of the gastric mucosa and, in parallel, limiting the aggression of predisposing factors causing gastric ulceration. The defenses of the gastric mucosa are incredibly efficient under normal mechanical, thermal or chemical conditions.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 6,986,901 B2 Meisel Et Al
    USOO698.6901B2 (12) United States Patent (10) Patent No.: US 6,986,901 B2 Meisel et al. (45) Date of Patent: Jan. 17, 2006 (54) GASTROINTESTINAL COMPOSITIONS 6,121,301 A 9/2000 Nagasawa et al. 6,127,418 A 10/2000 Bueno et al. (75) Inventors: Gerard M. Meisel, Budd Lake, NJ 6,156,771. A 12/2000 Rubin et al. S. Arthur A. Ciociola, Far Hills, NJ FOREIGN PATENT DOCUMENTS CA 967977 5/1975 (73) Assignee: Warner-Lambert Company LLC, CA 2136164 3/1995 Morris Plains, NJ (US) CN 1092314 3/1993 CN 1118267 5/1994 (*) Notice: Subject to any disclaimer, the term of this DE 9859.499 : 12/1998 patent is extended or adjusted under 35 E. O S. A1 3.10: U.S.C. 154(b) by 234 days. FR 2244469 8/1973 FR 4506 8/1993 (21) Appl. No.: 10/196,053 FR 277 1009 11/1997 JP 56128719 3/1980 (22) Filed: Jul. 15, 2002 JP 306.6627 8/1989 O O JP 9052829 6/1995 (65) Prior Publication Data WO WO 95.01803 A1 * 1/1995 US 2004/0013741 A1 Jan. 22, 2004 WO WO 9725,979 1/1996 WO WOOO765OO 12/2000 (51) Int. Cl. WO WOO121601 3/2001 A6IF I3/00 (2006.01) ZA 61O1840 8/1993 A6F 99.6A06 3032006.O1 OTHER PUBLICATIONS A6 IK 948 (2006.01) JW Read, JL Abitbol, KD Bardhan, PJ Whorwell, B Fraitag-"Efficacy and Safety of the peripheral kappa ago (52) U.S. Cl. ....................... 424/436; 424/422; 424/430; nist fedotoZine verSuS placebo in the treatment of functional 424/433; 424/451; 424/464; 424/489 dyspepsia see comments)." Gut Nov., 1997 41(5):664-8.
    [Show full text]